Shopping Cart
Your Cart is Empty
Quantity:
Subtotal
Taxes
Shipping
Total
There was an error with PayPalClick here to try again
CelebrateThank you for your business!You should be receiving an order confirmation from Paypal shortly.Exit Shopping Cart

Membership Application

Board of Directors

Konocti Senior Support, Inc.

Please click the SUBMIT button below when finished


If you prefer to download the paper version, please click here.

Will you be able to attend the Monthly Board meetings?*
Please check if you available to serve on any of these committees?*
This site uses Google reCAPTCHA technology to fight spam. Your use of reCAPTCHA is subject to Google's Privacy Policy and Terms of Service.

Thank you! Your message was sent successfully.